Survival of the fittest for Massachusetts hospitals

Monday

Dec 29, 2008 at 12:01 AMDec 29, 2008 at 1:01 AM

Hospitals, once secure in their community niches and service areas, are fighting for their survival. As they battle competition from the big teaching hospitals in Boston and independent outpatient centers in the suburbs, they face daunting challenges.

Sue Scheible

It’s survival of the fittest. Hospitals, once secure in their community niches and service areas, are fighting for their survival. As they battle the big teaching hospitals in Boston and independent outpatient centers in the suburbs, they face daunting challenges.

Keeping up with the latest expensive technology, from robots in the surgical suite to images only once dreamed of, is just one of the demands.

In their efforts to secure their place, they are turning more and more to their communities, anticipating trends and demographic changes, adding the services they hope most consumers most want, and drawing on ever shifting insurance payments. Fundraising is becoming more important than ever.

The South Shore hospitals below have transformed themselves in the past few years. Most have changed their names at least once and/or formed new alliances, often with Boston’s teaching hospitals in the lucrative fields of cardiology and other specialty care.

Richard Aubut, president and CEO
Biggest challenge? Finding, developing and keeping the very best medical, nursing and clinical talent is a significant challenge. Recruiting and retaining physicians is a nationwide challenge. South Shore Hospital has the largest medical staff in our region. One-third of our nation’s doctors is over the age of 55 and will retire in the next 10 years. The amount of physicians graduating from U.S. medical schools isn’t keeping pace with the numbers of doctors that will be needed to care for a growing and aging population.

Most excited about? The outpatient Cancer Center we will open in October 2009, in affiliation with Dana-Farber Cancer Institute and Brigham and Women’s Hospital and staffed by oncologists from Harbor Medical Associates, who will join Dana Farber staff

Most worried about? Everyone deserves to be treated with expertise, compassion and respect. Our biggest concern is making sure that all those who choose us for care are satisfied with the entire experience. And that is no small task. All of us who work at South Shore Hospital are very focused on the patient experience.

Biggest changes? Technology continues to revolutionize health care. People used to travel outside our region for minimally invasive and computer-assisted surgeries that are now available at our hospital. Treatments once provided in hospitals are now provided at home by our visiting nurses

Peter Holden, CEO and president
Biggest challenge? To provide high quality care and services, proving that our clinical outcomes are equal or superior to the Boston hospitals and we can do it 30 to 40 percent cheaper than the academic medical centers.

Most excited about? The relentless pursuit of continuous quality improvement and being able to measure those results. Clinical pathways or “care maps” enable us to provide the right care, in the right place at the right time. Jordan Hospital will be the obvious health care provider of choice for this region. Financial improvements will follow.

Most worried about? Reduced reimbursements; increasing regulatory requirements that make the practice of medicine very complex; the increasing costs of technology, pharmaceuticals and recruiting; and keeping clinical expertise are all significant challenges.

Biggest changes? Technology continues to revolutionize health care. There is always an inexhaustible need for services and limited resources to meet demand. If we develop good systems and support our physicians in practicing quality medicine, we will consistently be the best place for patients to receive care.

Dr. Gary Gibbons, CEO and president
Biggest challenge? We provide care to everyone, regardless of their insurance status, and work with diverse populations with special, and often costly, needs. We struggle with insufficient reimbursement to cover the cost of providing that care.

Most excited about? Our vibrant relationship with the community and our provider partners. We have exceptional high quality scores and our clinical affiliation with BMC is intact. We also have opportunities and strategies to build and strengthen our community’s health care system.

Most worried about? Shortages of doctors and nurses in primary care and medical specialties, like rheumatology and surgery. With declining reimbursement rates, there is a danger of further closure of community hospitals, especially those with higher government-payer mixes like QMC.

Biggest changes? Growing needs of baby boomers will require a rational payment system to ensure hospitals remain open to serve them. I’m encouraged by more public reporting and transparency because it empowers patients.

Norman Goodman, president
Biggest challenge? The belt-tightening that is necessary in health care and the need to carefully examine any cutbacks ... to ensure that we maintain standards for consistent, compassionate care to the 22 communities in our service area.

Most excited about? The Signature Healthcare organization, (including the) hospital and 16 other health services locations. We have some of the most cutting-edge technology and high-caliber doctors, nurses and others.

Most worried about? The governor’s recent cuts to health care and being guaranteed we will be adequately compensated for the true cost of the care we provide. The moves by larger hospitals to creep in (and) cherry-pick profitable services (like cardiac care, imaging and day surgery), while declining other costly but essential procedures.

Biggest changes? Changes in clinical practice and technology are happening almost faster than the human mind can absorb. Universal health coverage is the most exciting, complex and intriguing change in decades.

John J. Holiver, president
Biggest challenge? Reimbursements from third parties and the financial stress this places on community hospitals.

Most excited about? The continued growth of Caritas Good Samaritan and the new services in sleep, wound care and cancer care to meet our community’s needs.

Most worried about? Shortages in the key health care professions.

Biggest changes? Hospitals must provide exceptional service and attention to the total physical, medical, spiritual and emotional needs of patients and their families. We must have both hospitality and health care to meet and exceed patient expectations.

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